PTSD and Sleep: Why Trauma Disrupts Sleep and What Helps
If you have PTSD, it is likely that sleep problems affect your life seriously. It can feel helpless and out of control. You know sleep is important and would make you feel better, but you just canโt seem to get the rest you need. This is very common for people with the condition. PTSD and sleep problems co-occur more often than not. That said, there are things that can help.
Why exactly does trauma disrupt sleep? It is a physiological response. Regulating the nervous system through PTSD treatment and getting sleep-specific support helps people with PTSD get more adequate, higher-quality sleep. This often looks like trauma therapy paired with therapy for sleep, and sometimes, the addition of a medication that is appropriate for your needs.ย
People with PTSD can recover from sleep issues, and overcoming sleep problems also helps to improve PTSD symptoms, so itโs critical to seek professional treatment for more than just one reason.ย
The Connection Between PTSD and Sleep
Sleep disturbances affect about 80-90% of people with PTSD. For many people, though, the real question is: Why canโt I sleep with PTSD? When you have PTSD, hyperarousal (the fight-or-flight response) keeps you hypervigilant. Youโre unable to โswitch it off,โ which is what creates the โtired but wiredโ sensation so many people with PTSD live with day to day.ย
It is no secret that lack of sleep and poor sleep quality negatively affect mental and physical health. With PTSD, it becomes a vicious cycle. Poor sleep worsens trauma symptoms, and worsened symptoms disrupt sleep further.
How PTSD Disrupts Sleep – Common Patterns
Even though most people with PTSD struggle with sleep, the way the condition affects sleep can differ from one individual to another. Before treatment, many people with PTSD go through:
- Insomnia. Waking up too early or difficulty falling asleep.
- Hypervigilance at night. Being on edge or โkeyed upโ; feeling high-alert and awake, even if you were exhausted all day; can include racing thoughts, thinking about fears or negative beliefs (e.g., โI am bad,โ โthe world is not safe,โ โthings will not get betterโ), and/or physical symptoms.ย
- Trauma nightmares: Nightmares related to the traumatic event or emotions surrounding it.
- Sleep paralysis. You are conscious and aware of your surroundings, but you cannot move or speak. This can happen while falling asleep or after you wake up.ย
- Poor sleep quality. You (technically) sleep, but you donโt feel rested.ย
When you get adequate, quality sleep, your brain properly categorizes traumatic or emotional memories as something of the past. This process is actually physically disrupted when you donโt get enough sleep. It makes it even harder for your nervous system to understand that you are safe. Donโt worryโthis isnโt permanent! PTSD treatment in Michigan focuses on helping the nervous system understand that you are physically and emotionally safe.ย
How Sleep Deprivation Makes PTSD Worse
Since the brain doesnโt filter things properly when you donโt sleep, it makes sense that sleep deprivation can make PTSD symptoms worse. Unfortunately, this only deepens the exhaustion-and-hyperarousal paradox. The worsening of PTSD symptoms can show up in a lot of different ways. Recognizing them can be one of the first steps toward management.ย
Itโs scientifically documented that emotional regulation deteriorates when people donโt get enough sleep, even in those without PTSD. With PTSD and sleep deprivation, negative thoughts may take over. Intrusive memories and flashbacks intensify. Concentration, mood, and daily functioning decline. Difficulties like PTSD and anger, anxiety, or depression typically get worse.
A lot of people with PTSD feel desperate to sleep but struggle all or most nights, so the negative effects add up. Sleep becomes a daily or near-daily battle. No matter how long it has been going on for you, please know that there are effective treatments for PTSD and sleep issues.ย
What Actually Helps
A lot of people with PTSD feel theyโve tried everything for sleep to no avail. In reality, itโs more that public awareness surrounding what really works (and PTSD as a cause) is often limited. Specialized treatments are key. There are effective therapies for PTSD sleep disturbances.ย
- CBT-I: Cognitive Behavioral Therapy for Insomnia (CBT-I) is the first-line treatment for insomnia. It focuses on changing thoughts, fears, and sleep habits that perpetuate insomnia.ย
- Imagery Rehearsal Therapy: Imagery Rehearsal Therapy (IRT) was designed specifically to reduce the frequency and intensity of chronic nightmares in PTSD. It is a short-term treatment that helps you โrewriteโ or rescript PTSD nightmares.ย
- Trauma-focused therapy. First-line treatments for PTSD, like EMDR, address trauma as an underlying cause. Effective trauma treatment improves your mental health overall while making you less vulnerable to the cyclic nature of trauma and sleep disorders.ย
Sleep hygiene is a crucial foundation. It doesnโt have anything to do with being clean: it refers to practices known to aid sleep, such as a no-blue-light policy before bed, sleeping in a cool, dark room, and using the bed only for sleep and sex. When appropriate, medication can be combined with therapy and sleep hygiene.ย
When to Talk to a Professional
How do you know if itโs time to talk to a professional? Please seek help for sleep disturbances and trauma if:ย
- Sleep disruption persists for weeks or months
- Exhaustion affects your work, relationships, or safety
- Your nightmares are repetitive or ongoingย
- You self-medicate with alcohol or other substances to sleep
If youโre wondering how to sleep better with PTSD, you deserve effective treatment. Finding a provider who can evaluate your symptoms and work with you to create a personalized treatment plan matters.
Get Help for PTSD and Sleep in Michiganย
PTSD-related sleep problems are not a weakness. Your nervous system is trying to protect you; itโs possible to feel safer so that it doesnโt have to work in overdrive anymore. If PTSD is keeping you from sleeping, Sanford Behavioral Health is here. We use evidence-based approaches to treat PTSD and sleep disturbances. To learn more about PTSD treatment at Sanford, call 616.202.3326 or contact us online, 24/7.
Frequently Asked Questions
Do people with PTSD sleep a lot or not enough?
Most people with PTSD struggle with not getting enough sleep, waking up at night, or disturbed sleep. However, a smaller number of people with PTSD do sleep a lot and may experience chronic exhaustion no matter how much sleep they get.ย
Why do I keep having nightmares about my trauma?
Nightmares are a common PTSD symptom. Getting an evaluation for PTSD can help you get a proper diagnosis. Usually, this is the first step toward appropriate treatment.ย
Can PTSD cause insomnia?
Yes. Insomnia is one of the most common sleep problems PTSD can cause. It is possible to overcome PTSD insomnia through treatment. Getting specialized treatment for both conditions (not just one or the other) supports the best outcomes.ย
Does treating PTSD improve sleep?
Yes. With evidence-based PTSD treatments like EMDR, many experience improvements in symptoms overall, which can include better sleep quality and a reduction in PTSD nightmares. However, many people also need sleep-specific interventions. Sleep-specific interventions (like CBT-I) should be used in addition to PTSD treatments for a comprehensive approach in people who have PTSD.
